A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy.
OBJECTIVE
The purpose of this study was to compare outcomes in women who underwent endometrial cancer staging by different surgical techniques.


METHODS
Three hundred twenty-two women underwent endometrial cancer staging: 138 by laparotomy (TAH); 81 by laparoscopy (TLH) and 103 by robotic technique (TRH).


RESULTS
The TRH cohort had a higher body mass index than the TLH cohort (P = .0008). Lymph node yield was highest for TRH (P < .0001); hospital stay (P < .0001) and estimated blood loss (P < .0001) were lowest for this cohort. Operative time was longest for TLH (213.4 minutes) followed by TRH (191.2 minutes) and TAH (146.5 minutes; P < .0001. Postoperative complication rates were lower for TRH, compared with TAH (5.9% vs 29.7%; P < .0001). Conversion rates for the robotic and laparoscopic groups were similar.


CONCLUSIONS
TRH with staging is feasible and preferable over TAH and may be preferable over TLH in women with endometrial cancer. Further study is necessary to determine long-term oncologic outcomes.
Boggess
John F
JF
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA. jboggess@med.unc.edu
Gehrig
Paola A
PA
Cantrell
Leigh
L
Shafer
Aaron
A
Ridgway
Mildred
M
Skinner
Elizabeth N
EN
Fowler
Wesley C
WC
D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D010052:Ovariectomy; D012371:Robotics; D016896:Treatment Outcome